Microbes outnumber human cells 10 to 1 and play important roles in human health and disease. While some microbes cause illness, most are harmless or beneficial. Microbes are found everywhere including in the air, water, soil, and inside and on the human body. They aid in digestion and prevent infection. However, overuse of antibiotics has led to increased antibiotic resistance in microbes, threatening our ability to treat infectious diseases. Antibiotic resistance occurs as bacteria evolve and share DNA allowing them to survive drug exposure. Prudent antibiotic use is needed to slow the development and spread of resistant microbes.

1. HOW MICROBES RULE THE WORLD?
Dr.T.V.Rao MD
When I was a Undergraduate Medical Student I had least understanding what Microbes mean to me,
We were passing Microbiology the examination, with little knowledge on few bacteria, when I
became a post graduate my imagination changed and I am in the sea of microbes. In fact, of late I
realised as we couldn't live without them. Microbes are everywhere - a largely unseen world of living
things that support life processessome microbes cause disease, but most are harmless or even
helpful. Microbes outnumber our own cells ten to one. They may live as individuals or cluster
together in communities. Microbes live in the water we drink, the food we eat, and the air we
breathe. Right now, billions of microbes are swimming in our intestines and mouth, and crawling on
our skin! Don't worry, over 95% of microbes are good for us. Microbes include bacteria, viruses,
fungi, algae, and protozoa. Many commensal and useful bacteria in our mouth prevent fungal
growth. Our forearm is home to over 100 species of bacteria that keep our skin healthy. We also
have about three pounds of useful bacteria in our digestive tract that help us digest food. They break
down carbohydrates and provide us with essential vitamins. And we're not the only ones that
benefit from a relationship with microbes. Every plant and animal unknowingly houses trillions of
them.There is some evidence that microbes may have an indirect role in cancer. For example, some
microbes cause inflammation, which appears to increase cancer risk. Microbes live in the farthest
reaches of the atmosphere. Microbes may inhabit space beyond our world. The air around us is filled
with microbes. Bacteria, fungi, algae, protozoa, and viruses float in air currents. The numbers of
microbes in the air range from 10 to 10,000 per cubic meter. Think every time we are breathing
many, many microbes are inhaled, however whatever we do we cannot avoid inhaling, never forget
many common infections are Respiratory, in spite of mask we wear.
A number of microbes also have more direct connections to cancer. H. pylori bacteria, a common
cause of gastric ulcers, is also associated with cancers of the stomach and oesophagus. In our final
MBBS surgery examination we all must tell that cause of Peptic ulcer was Curry, Hurry and Worry, I
still remember some of the students snubbed when they failed tell these facts, thanks to science
Warren and Marshall proved every one of us and our teachers, wrong with discovery of H.Pylori A
number of viruses cause cancer as well: Hepatitis B and C greatly increase the risk of liver cancer; the
sexually transmitted HPV (human papilloma virus) is associated with many cervical cancers; and EBV
(Epstein-Barr virus, the cause of mononucleosis) is associated with lymphomas (cancerous white
blood cells) and other cancers. Today’s concern is action and reaction associated with Antibiotic use,
in the past Antibiotics were like magic bullets, as with irrational use of Antibiotics the use of is a
concern to the health and society with arise of multi drug resistant strains, as common man
understands as SUPER BUGS. "Antibiotic resistance is an inevitable consequence of antibiotic use,
the more you use them the more resistance you will get. To understand the basics, Antibiotic
resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic
resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of
drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and
continue to multiply causing more harm.Almost every type of bacteria has become stronger and less
responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can
quickly spread to family members, schoolmates, and co-workers - threatening the community with a
new strain of infectious disease that is more difficult to cure and more expensive to treat. For this
reason, antibiotic resistance is among *CDC's top concerns. Bacteria can also acquire resistance. This
happens when a type of bacteria changes in a way that protects it from the antibiotic. Bacteria can
acquire resistance in two ways: either through a new genetic change that helps the bacterium

2. survive, or by getting DNA from a bacterium that is already resistant. Antibiotic use promotes
development of antibiotic-resistant bacteria and spread to many in the Hospital environment casing
many Hospital acquired infection. Every time a person takes antibiotics, sensitive bacteria are killed,
but resistant Bactria may be left to grow and multiply. Repeated and improper uses of antibiotics are
primary causes of the increase in drug-resistant bacteria. In addition, bacteria that were at one time
susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by
acquiring pieces of DNA that code for the resistance properties from other bacteria. The DNA that
codes for resistance can be grouped in a single easily transferable package, and as Plasmids. This
means that bacteria can become resistant to many antimicrobial agents because of the transfer of
one piece of DNA. The emergence of antibiotic resistance creates a new challenge for public health,
and there is no simple solution. Genetically, antibiotic resistance spreads through bacteria
populations both "vertically," when new generations inherit antibiotic resistance genes, and
"horizontally," when bacteria share or exchange sections of genetic material with other bacteria.
Horizontal gene transfer can even occur between different bacterial species. Environmentally,
antibiotic resistance spreads as bacteria themselves move from place to place; bacteria can travel via
airplane, water and wind. People can pass the resistant bacteria to others; for example, by coughing
or contact with unwashed hands. To treat a resistant infection and prevent resistance from
spreading, doctors sometimes prescribe a broad-spectrum approach when they do not have optimal
support of Microbiology Departments, and irrational physicians who treat the patients without
scientific rationalism,this approach combines multiple antibiotics that attack bacteria in different
ways. It can work better because it is unlikely that a single bacterium will be resistant to multiple
antibiotics. Yet for the same reason, this approach kills many more friendly bacteria and can cause
related health complications. The question remains, Can bacteria lose their antibiotic resistance?
Yes, and it is possible antibiotic resistance traits can be lost, but this reverse process occurs more
slowly. If the selective pressure that is applied by the presence of an antibiotic is removed, the
bacterial population can potentially revert to a population of bacteria that responds to antibiotics.Do
not forget the world is heading towards a post-antibiotic era, in which many common infections will
no longer have a cure and once again, kill unabated. Think before prescribe an antibiotic, we cannot
kill all the Microbes we desire, many escape if we do not use rationalism in Antibiotic use?
Prescribing an Antibiotic Today needs more wisdom than in the past? (Ref CDC on antibiotics)
Dr.T.V.Rao MD Professor of Microbiology Freelance writer