Madison Area Lyme Support Group

Antibiotic resistance is a race between us humans, who strive to find new antibiotics that can treat infectious diseases – and bacteria, which are becoming increasingly resistant. For now, bacteria are way ahead, which is why it is important for us to learn more about antibiotic resistance. A Danish research group has discovered a new piece of the puzzle that helps us better understand the ‘enemy’.

University of Copenhagen researchers have shown that the prevailing assumption that resistant bacteria lose their resistance capability when antibiotics are not present is a truth requiring significant modifications.

“One widespread strategy to combat antibiotic resistance has been to use antibiotics for a period of time and then take a break. The belief is that resistant bacteria will lose their resistance genes or be outcompeted during the break, after which the antibiotics will work again. But that approach doesn’t seem to hold up,” says one of the study’s senior authors, Associate Professor Mette Burmølle of the Department of Biology. Co-first author Henriette Lyng Røder elaborates:

“Our study demonstrates that resistance genes are able to hide in inactive bacteria, where they form a hidden reserve of resistance that bacteria can rely on. In other words, they don’t just disappear when antibiotics aren’t around.”  (See link for article)

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Summary:

• The study, found in NPJ Biofilms and Microbiome, is called: “Biofilms Can Act as Plasmid Reserves in the Absence of Plasmid Specific Selection”
• The article of course delves into biofilms, something every Lyme/MSIDS patient must quickly learn about.
• It has long been thought that using antibiotics and then taking a break would eradicate any lingering bacteria either through losing resistance genes or being out-competed.
• The study found that resistance genes hide in inactive bacteria and form a hidden reserve.
• Inactive bacteria found in biofilm have this hidden reserve of resistance genes that can be drawn upon. (Think of it as a special army that can be called upon when other soldiers are killed or injured)
• Plasmids, which allow resistance genes to occur, also steal energy from bacteria and cause it to grow more slowly, so the bacteria strike the perfect balance by having active bacteria do the heavy lifting while inactive (hibernating) bacteria in biofilm have the life-sucking plasmids slowing them down but make them antibiotic resistant which is imperative for survival.
• Researchers believe that resistance/persister reserves in biofilms are primarily built up in environmental bacteria found in soil, air, and wastewater.
• Different species of bacteria can transmit resistance to each other, which means environmental bacteria found in soil for instance can be transmitted to the types of bacteria (say staph, for instance) that make people ill.
• A concern is that antibiotic-resistant genes from humans and animals that ends up in sewage for instance may spread into the environment and turn environmental bacteria pathogenic or disease causing.

Important quote:

“In the bigger picture, this means that if there are a lot of inactive bacteria in the environment, in soil for example, then resistant genes don’t just gradually disappear when antibiotics aren’t present. Therefore, we ought to consider abandoning the idea that we can get rid of resistance genes and instead assume that they are always present. Understanding these dynamics can better equip us to battle antibiotic-resistant bacteria.”

Could someone please send this to the IDSA?

When I first read this, I completely missed the “new hiding place,” as this has been discussed for years by Lyme/MSIDS researchers and doctors.

• Dr. Zhang calls them “persisters.”
• Dr. Horowitz has had great success in a subset of patients using mycobacterium drugs and states: “the efficacy of dapsone combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS)” [2] “decreased eight major Lyme symptoms severity and improved treatment outcomes among patients with chronic Lyme disease/PTLDS and associated co-infections.”
• A study by Stanford Medicine suggests that the antibiotic azlocillin “completely kills off the disease-causing bacteria Borrelia burgdorferi at the onset of the illness.” In addition, the authors say, azlocillin “could be effective for treating [Lyme disease] patients infected with drug-tolerant bacteria that may cause lingering symptoms.” [5]
• Researchers from Johns Hopkins School of Public Health found that a combination of antibiotics – daptomycin, doxycycline, and ceftriaxone − eradicated the slow-growing variant form (persisters) of the Lyme bacteria in a mouse model. Scientists believe persisters may be responsible for the chronic symptoms that some Lyme disease patients experience.  “There is a lot of excitement in the field because we now have not only a plausible explanation but also a potential solution for patients who suffer from persistent Lyme disease symptoms despite standard single-antibiotic treatment,” says Ying Zhang, MD, Ph.D., senior author on the study.
• Dr. Mass has written that Disulfiram/Antabuse not only kills the active bacteria responsible for the disease but also a subpopulation of “persister-cells”.
• This study shows how important it is to continue to play in the dirt and eat things from the ground.  Soil-based probiotics are bacteria naturally found in the earth. One of the most common types of soil-based probiotics (bacillus) has been used to ferment foods for hundreds of years.
• Make sure you work with a reputable practitioner to become educated on the nuances of nutrition, probiotics, supplements, and other things that will help you
• COVID has ignited a germ-fear panic which is unfounded and truly contrary to everything known about human health and germs/viruses.  The constant de-germing of every surface is killing beneficial bacteria and setting us up for illness. As with all things in life – it’s about balance.  When there’s too many bad-guys, your health will tip into illness, but when all is in balance, health is robust and stable.  Our job?  Try to find that proper balance, which is a lifetime work!  And, as with all things, looks slightly different on each individual, which is why allopathic medicine will never have the answers as it is a “one-sized fits all” approach where supposedly a singular pill will fix you and everyone else in exactly the same way.  Hopefully we can put that myth to rest once and for all, as this over simplification of health is leaving thousands in the dust – particularly Lyme/MSIDS patients.