Every day that 29-year-old microbiologist Hosam Zowawi spends in his laboratory makes him more aware that a nightmare scenario in which modern drugs fail to work could become reality.
For his Ph.D at the University of Queensland in Brisbane, Australia, Zowawi is studying the way that bacteria develop resistance to antibiotics that help people combat life-threatening infections such as pneumonia. While resistant strains of bacteria have been recognized for some time, microbiologists like Zowawi are increasingly discovering strains that are immune to all known antibiotics, rendering them so resilient that they have been dubbed “superbugs”. Zowawi is studying patients who are dying of common conditions such as urinary tract infections – which would normally be treatable – because they harbour antibiotic-resistant bacteria.
Existing diagnostic tests are too slow to detect resistant bacteria, taking between 48–72 hours to yield results. This is too long for many patients who need urgent treatment, so doctors use trial and error to identify an antibiotic that works. Zowawi has developed a Rapid Superbug test that gives results in just three to four hours, potentially allowing doctors to prescribe an appropriate antibiotic. Zowawi’s test searches bacteria for genes that make beta-lactamase enzymes, which enable bacteria to destroy an important class of antibiotics including penicillin and carbapenems before they can do their work. This is an issue of global concern because drugs such as carbapenems are often used as antibiotics of last resort. Zowawi is also developing a second test that will identify a family of bacteria that is particularly prone to developing antibiotic resistance. Both tests require highly specialized scientific equipment.
Zowawi is particularly interested in how superbugs are spreading through the Gulf states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates). In many of these states, as in other parts of the world, poor prescription practices and the fact that antibiotics are sold freely over the counter mean that many people either take the wrong antibiotics, or take them when they are unnecessary, such as for viral infections. This misuse of antibiotics fuels bacterial resistance greatly, which is why a key component of Zowawi’s project involves raising awareness of the issue. “In the Gulf, some hospitals train doctors on antibiotic resistance, but there is very little information given to the public.”
Since antibiotic-resistant bacteria can easily cross borders with people or animals, it was important for Zowawi to establish a region-wide system for monitoring antibiotic resistance. Unfortunately, many Middle-Eastern countries are unaccustomed to extensive cross-border collaboration. As Zowawi’s Ph.D kept him busy in Brisbane, establishing a network meant “long days and nights in front of my computer, firing off endless emails, convincing hospitals to take part”. The effort has paid off, and Zowawi now has a collaborative network of seven Gulf-region hospitals that have agreed to share data about antibiotic-resistant bacteria.
The campaign – the first region-wide Gulf effort of its kind – will include educational documentaries, flyers and infographics, and will make use of social-media platforms such as Twitter and YouTube. Zowawi is also consulting media experts to produce content for television, radio and newspapers. Communicating information about science only works well when it adapts to cultural and social mores, says Zowawi. “The beauty of our campaign is that it has a local perspective and not a Western one. The data and case studies all come from our research in the Gulf countries. This will help people really identify with the issues.”