Molecular genetics and the foundations of evolution.
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As the Science of Biology is constantly changing due to new discoveries and advanced techniques it is essential that a systematic study of the environmental causes of natural selection on microorganisms be conducted. Very small phenotypic differences among individuals within bacterial populations arise as a result of spontaneous genetic variation, but the evolutionary importance of these small changes is frequently considered to be non-significant. Recent in vitro experiments indicate that efficient selection of these very small differences may take place in environmental compartments where a particular intensity of the selective agent is exerted. Model studies based on competition between bacterial populations only differing in one or two amino acid changes of a detoxifying antibiotic enzyme (e.g. beta-lactamase) have shown that at a narrow range of antibiotic concentrations the variant population is strongly selected over the original type, despite the extremely low phenotypic differences in antibiotic susceptibility. These selective concentrations are expected to occur in precise environmental compartments (selective compartments). Due to the high frequency of structured habitats in natural environments, the intensity of selective agents is commonly exerted along certain gradients. Each one of the points forming these gradients (or intersection among gradients) may have a particular selective ability for a specific genetic variant. Considering the environment as a composition of an extremely high number of specific selective compartments may help to understand the existence of high levels of genetic variability in natural bacterial populations. This may be one of the clues towards the unraveling of bacterial evolution.
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Comparison of resistance genes from different sources support the hypothesis that the antibiotic-producing microorganisms are the source of resistant determinants present in clinical isolates. There is also evidence that Gram-positive cocci (staphylococci and streptococci) can serve as a reservoir of resistance genes for Gram-negative bacteria.
The authors studied the susceptibility to 5 aminoglycosides (amikacin, dibekacin, gentamicin, netilmicin and tobramycin) of 3,354 strains isolated at the Centre Hospitalier Sud in Bordeaux during 1987. The results are compared to those obtained in 1984 on 2,818 strains. Amikacin remains the most active aminoside against the Enterobacteriaceae and Acinetobacter; against Pseudomonas, tobramycin has become the best one at that time, as well as netilmicin against Staphylococcus aureus. Evolution: no significative increase of Enterobacteriaceae resistance to aminoglycosides was observed during the last 3 years except for Providencia and Serratia. For Acinetobacter and Pseudomonas, percentage of resistant strains is respectively two-fold and three-fold higher. Although resistance increased in that species, netilmicin and amikacin showed a still good activity against Staphylococcus aureus.
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Metchnikoff was one of the first to suggest the need for cooperation between phagocytes and therapeutic agents for the benefit of health. After the hopes raised by the discovery and the tremendous development of antimicrobials, there is now a creeping pessimism faced with the parallel evolution of resistance strategies in the microbial world. Interest has now turned to the use of immunomodulatory drugs, alone or combined with anti-infectious agents. Another tendency is based on the possibility that antimicrobials directly interfere with the host-microbe interplay. This review is aimed at summarizing our knowledge of the interactions between antimicrobial agents and the phagocyte, still a cornerstone in the natural defence system. Despite the problems inherent in the analysis and clinical relevance of effects observed in the test tube this developing area of research could provide new therapeutic solutions beyond the year 2000.
The value of the precious medical asset that antibiotics constitute is contimualby being eroded by the spread of resistance. For some time that bacterial world has been adapting itself to contend with the toxic assault of man-made poisons, antibiotics, by developing resistance in a very rapid process of evolutionary changes occurring before our very eyes. This evolutionary adaptation is an example of natural genetic engineering entailing an interchange between bacteria of genes conferring antibiotic resistance. Trimethoprim resistance is an example where numerous genes of unknown origin (some closely interrelated), expressing drug-resistant dihydrofolate reductases, move among human commensals and pathogens. They have been shown to move as gene cassettes in and out of the recently characterised integron structure occurring in many pathogens. They are also carried by various transposons such as Tn7, or Tn5393 originally observed in a plant pathogen, Erwinia amylovora. Betalactam resistance is another example of natural genetic engineering, where new betalactamases are continually emerging, and individual enzyme substrate specificity is modified by point mutation. At present, betalactamase mutants resistant to all commercially available betalactams, including clavulanic acid used in combination with betalactam antibiotics, are to be found in clinical isolates. Thus, currently bacteria seem to be triumphing in the running battle between the pharmaceutical industry and the bacterial world, the former introducing one new antibiotic variant after another, to which bacteria promptly develop resistance by manipulating their own genomes.
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The simplest conceivable event that can occur at the gene level can result in the development of efficacious resistance tot antibiotics. The bacterial world behaves as an enormous organism whose cells can exchange their genes very easily. Accordingly, opportunities for the exchange of genetic material in nature are probably unlimited. This knowledge cannot be ignored. It leads to the important conclusion that the antibiotics are societal drugs. A resistance gene which has appeared somewhere in the world can travel far and fast.