How bacteria become resistant to antibiotics
Bacteria, like all living things, adapt to new environments. Every time they are exposed to antibiotics, there is a small chance that they will adapt and survive. And with the widespread use of antibiotics over recent decades, bacteria have had a lot of opportunities to increase their resistance. This has become a very serious problem, as well as a very complex one. In different locations, different types of bacteria have grown resistant to different types of antibiotics. In places where there is violent conflict – such as many locations in the Middle East – the problem is even more complex.
“A war wound has an enormous potential for bacterial infection,” says Dr Jorgen Stassijns, who is coordinating MSF’s efforts to get a grip on the problem of antibiotic resistance. “A bullet or a piece of shrapnel rips the skin apart and rips the flesh open, allowing bacteria to get in, while if you step on a landmine, lots of dirt will be blown into the fresh wound immediately. The risk of an infection is huge.”
Take Waleed, a patient in MSF’s reconstructive surgery hospital in Amman, Jordan. In 2016, he was walking down the street in the Yemeni town of Ibb when an aircraft opened fire at the building next to him. A wall collapsed, severely injuring his jaw and leg. The impact of a bullet, an explosion or a collapsing wall on the human body can be major. It can cause significant internal damage, often requiring surgery to put it right. Complex bone fractures, for instance, may require multiple surgical interventions, increasing the risk of a bone becoming infected – if it was not already infected when the body was first injured.